Over the past few decades, the United States of America has been hit by a huge nursing shortage. Shortage of nurses refers to the inadequacy in the number of professionally qualified nurses who can provide the required health care services to the public at the demand level in the healthcare facilities (Shi & Singh, 2008). The shortage menace has been projected to continue in the near future, a fact that jeopardizes the achievements of various health policy goals. The bureau of US labor statistics postulates that the shortage in the number of nurses is expected to hit the 500,000 mark by the year 2025, which would be disastrous to the country’s health status (Feldman, 2006). This decline will have a lot of negative impacts on the delivery of services to the public. Due to the severity of the nursing crisis in the United States of America, this paper will evaluate the causes of the nursing shortage menace. The paper will also examine the possible impact of this shortage on the achievement of the health care policy. The issue of nursing shortage was selected because of its persistent nature over the previous decades, despite elaborate measures to reverse the same.
Several factors can be attributed to the decline in the number of nurses in the country and the world at large. Firstly, there has been an increase in career alternatives for young people to embrace. Unlike in the past where career pursuits were limited, the rise of information technology and globalization has presented various work opportunities such as home-based works among others. With newer career pursuits that are perceived to have lesser stressors, more young people are opting to shun nursing. Among the main factors that have made nursing to be unattractive to the younger generation is the professional commitment that comes with nursing. Nurses may be required to report for duty in odd hours, which makes the career unattractive. Most of the young people are opting to pursue different career paths where they can actualize their quality of life thus resulting in the nursing shortage.
Secondly, there has been a drastic increase in the population in the country. The American population has finally hit the three hundred million marks. The growth in the population ought to be matched with similar growth in service provision sectors. However, as the population grows, there has been insignificant growth in the number of students enrolling for nursing courses thus affecting the patient-nurse ratio. The American population has also experienced a growth in the health-conscious segment of the population further affecting the patient-nurse ratio.
Another major cause of nursing shortage in the United States as identified by Shi and Singh, (2008), is the feelings of subordination of the nurses by the medical practitioners. According to Shi and Singh, (2008), nurses express their dissatisfaction with their work due to the feelings of being subordinated by the doctors they work under. Their efforts are thus not effectively recognized which makes them lack motivation towards their roles. Those who express these feelings argue that the doctors they serve under bags all the recognition for their efforts towards disease eradication while the nurses provide vital support services that are not provided by the doctors. They also argue that the role of the doctors cannot be carried out without the services of the nurses and thus the doctors should not take fame by subordinating them.
According to Feldman, (2006), the feeling of subordination by the doctors has resulted in the nursing profession being viewed as a less attractive one. This probably offers the explanation why there are fewer people pursuing nursing today while the population is increasing. The feeling of subordination, which has been linked to the poor motivation of nurses, has led to fewer nursing students as the current professionals in the nursing realm discourage the potential nurses from taking these courses. This has led to a scenario where former nurses leave the profession due to natural causes such as death or due to retirement and few people are readily available to fill in those positions. The unmatched turnover of nursing personnel leads to the reduction of nurses in American hospitals.
Another major cause of the nursing shortage as identified by Nagelkerk, (2006), is the changing policies in the health care industry. Nagelkerk, (2006), argues that nurses do not object to the changes that are introduced to the health care industry, but they feel that they should be consulted as major stakeholders of the health care industry. One major policy that has been identified by Nagelkerk, (2006), that lacks the input of nurses is the continued overemphasis of the need for cutting the cost of healthcare provision. Although Nagelkerk, (2006), points out that the nurses agree that health care provider needs to be affordable to all global citizens they feel ambushed by the fact that they are not consulted and thus, the policies that are suggested are foreign in the sense that they lack their input. The nurses lack ownership of such policies and more so, they feel that their role as major stakeholders in the health care industry is taken for granted as their input is ignored.
Effects of the Nursing Shortage on the Health Care Policy
The continued nursing shortage is set to have major effects on the implementation of the health care policy. This is because nurses play a crucial role in the implementation of the health care policy and therefore, any issue that has a direct or indirect effect on the nurses is bound to affect health care policy. One major issue that has been given paramount importance in the health care policy is the issue of accessibility to health care services. The health care services are provided by medical personnel and nurses. Any issue that jeopardizes the supply of that personnel would have a direct impact on the provision of health care services. The nursing shortage in the United States may cause a major detriment to the provision of health care services. Nursing services may fail to be accessible due to the rising demand for their services against a shrinking supply. Therefore, the issue of shortage of nurses in the United States of America may cause a major detriment to the achievement of the health care policy that aims at guaranteeing accessibility of health care services.
Another major detriment that the nursing shortage may cause to the health care policy concerns its affordability. One major concern of the global health care policy is the overall affordability of health care services. However, with a declining number of nurses, this target may not be realized especially due to the costs of paying nurses (Buerhaus, Staiger & Auerbach, 2009). The high cost for nurses may be driven by the forces of the demand and supply where the number of nurses declines against rising demand. This may drive the average wage rate for the nurses up which would, in turn, affect the affordability of the health care services.
The nursing shortage menace may also have a quality effect on the health care policy. The global health care policy targets to provide all citizens with quality and affordable health care services. The provision of quality services calls for elaborate measures that would guarantee that there is enough supply of personnel. The importance of an adequately trained workforce that meets the standard patient-nurse ratio remains an important aspect of the quality of services that can be provided by a health care unit. When the average number of nurses declines, the available nurses become overworked which in turn, affects the quality of their productivity. A high patient-nurse ratio would jeopardize the achievement of the health care goal to offer quality health care. The quality of the provided services may also be jeopardized by poorly trained nurses as the shortage may necessitate a hurriedly convened nursing training program to cater for the shortage. Such desperate measures may lead to a sharp decline in the bench-marked quality of service in the health care industry (Ellis & Hartley, 2004).
Implications to the Future Nursing Practice
The nursing shortage menace will have devastating effects on the nursing practice in the future. One of the effects would be on service delivery. When the number of nurses decreases against a rising population, the few available nurses will have to work extra hard to meet the demand for their services. This may have a detrimental effect on the quality of service delivered as the overworked nurses cannot be in a position to offer quality services.
The shortage of nurses coincides with a period when the demand for nursing care is expected to balloon in a projected period of 20 years. As the population ages and the baby boomers join the 65 and 85 age brackets, there will be an increased demand for nursing services which will make the nursing profession require more nurses. The US Bureau of Labor statistics postulates that the nursing profession will experience the seventh-highest growth rates in the next two decades. With such projected growth in demand for nurses, the drop in the number of nurses per capita makes the overall provision of nursing services jeopardized.
The nursing shortage may also impact negatively the costs of services provided. When the nurses become scarce and their demand raises, their remuneration will have to go high. Such a change in the nursing field will result in a tremendous increase in the overall cost of health care services. Increased costs of nursing may result in failure of affordability of nursing services thus affecting the overall health of the population. This may in turn affect the lifespan of the American population due to early deaths caused by poor nursing care.
Another future implication to the field of nursing would be the rise in the need to import manpower to cater to the shortage. Currently, there are hundreds of immigrant nurses working in the United States of America. The contribution of these nurses to alleviate the shortage of nurses cannot be ignored. However, should the shortage of nurses persist, the country may be forced to rely on foreign-trained nurses who may opt to work in the United States of America due to better-paying nursing opportunities.
To correct the nursing shortage menace, there is a need for elaborate measures to be adopted to ensure that the issues identified as the major causes of the nursing shortage are resolved amicably. The projected population growth should be matched with a growth in the supply of nurses to guarantee that the nurse-patient ratio is kept intact. Students should be encouraged to take nursing courses by introducing incentives to lure more students into taking these courses. Major factors that kill the motivation of nurses such as feelings of subordination by the medical professionals and lack of consultation for major aspects in the realm of health policy formulation should be addressed. Such measures would ensure that the rising population and the rise in a health-conscious group of people are matched with the rise of health care providers and not the reverse as is the case today.
In conclusion, it is evident that the nursing shortage menace is an issue of paramount importance to all stakeholders in the health care industry. Although this problem has been identified as a global problem, the main causes of this shortage in the developing world and developed nations like the United States are different. While the United States and other developed countries have all the needed resources to train enough nurses, there is a sharp decline in the number of people who embrace these courses. Developing nations experience nursing shortages due to the lack of adequate training funds. This difference in causes of shortage of nurses calls for corrective measures on the parts of the developed world.
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Ellis, J., R. & Hartley, C., L. (2004). Nursing in today’s world: trends, issues & management. New York: Lippincott Williams & Wilkins.
Feldman, H., R. (2006). The nursing shortage: strategies for recruitment and retention in clinical practice and education. New York: Springer.
Nagelkerk, J. (2006). Leadership and Nursing Care Management. Chicago: Elsevier Health Sciences.
Shi, L. & Singh, D., A. (2008). Delivering health care in America: a systems approach. New York: Jones & Bartlett Learning.